State Farm Fire & Casualty Co. v. Workers' Compensation Appeals Board

947 P.2d 795, 97 Daily Journal DAR 15207, 16 Cal. 4th 1187, 62 Cal. Comp. Cases 1629, 97 Cal. Daily Op. Serv. 9452, 1997 Cal. LEXIS 7907, 69 Cal. Rptr. 2d 602
CourtCalifornia Supreme Court
DecidedDecember 18, 1997
DocketS057387
StatusPublished
Cited by11 cases

This text of 947 P.2d 795 (State Farm Fire & Casualty Co. v. Workers' Compensation Appeals Board) is published on Counsel Stack Legal Research, covering California Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Farm Fire & Casualty Co. v. Workers' Compensation Appeals Board, 947 P.2d 795, 97 Daily Journal DAR 15207, 16 Cal. 4th 1187, 62 Cal. Comp. Cases 1629, 97 Cal. Daily Op. Serv. 9452, 1997 Cal. LEXIS 7907, 69 Cal. Rptr. 2d 602 (Cal. 1997).

Opinions

Opinion

MOSK, J.

Patrick A. Leonard, Jr., filed a claim for workers’ compensation benefits after he was injured while employed by his father, Patrick A. Leonard, Sr., to perform repairs on a vacant residential property. Leonard, Sr., was insured under a policy of comprehensive personal liability insurance (hereafter the policy), issued by State Farm Fire and Casualty Company (hereafter State Farm), that included an endorsement covering workers’ compensation benefits for so-called “residence employees,” defined in the policy as employees who “perform[] duties ... in connection with the maintenance or use of the residence premises.”

This case presents the question whether Leonard, Jr., is a covered employee under the workers’ compensation law and the State Farm policy. We [1191]*1191conclude that the answer is yes. Accordingly, we reverse the judgment of the Court of Appeal, which responded in the negative.

I.

In January 1989, Leonard, Sr., and his wife purchased a homeowners policy from State Farm. The policy included coverage for comprehensive personal liability and included an “Additional Coverage Endorsement” for workers’ compensation benefits with respect to “residence employees.”

The policy defines “residence employee” as “an employee of an insured who performs duties, including household or domestic services, in connection with the maintenance or use of the residence premises. This includes employees who perform similar duties elsewhere for [the insured]. This does not include employees while performing duties in connection with the business of an insured.”

The “Additional Coverage Endorsement” states that State Farm agrees, with respect to “residence employees,” as follows; “Under Coverage I [U To pay when due all benefits required of an insured by the California Workers’ Compensation Law; and [‘JD Under Coverage II [<J] To pay on behalf of an insured all damages for which the insured is legally liable because of bodily injury sustained by a residence employee.” It states that the insurance is subject to all of the provisions of the endorsement and to specific provisions of the policy, including the definition of “residence employee.”

In a section entitled “Who is Covered,” the Additional Coverage Endorsement states: “A residence employee is covered if during the 90 calendar days immediately before the injury the employee has: [‘JQ (a) actually been engaged in such employment by the insured for no less than 52 hours; and [<][] (b) earned no less than one hundred dollars ($100) in wages.”

In a section entitled “Exclusions,” the Additional Coverage Endorsement states, in relevant part: “This policy does not apply: [<fl] (a) to liability for additional compensation imposed on an insured under Sections 4553 and 4557, Division IV, Labor Code of the State of California, because of the serious and willful misconduct of an insured, or because of bodily injury to an employee under 16 years of age and illegally employed at the time of injury; [f] (b) to liability for bodily injury arising out of business pursuits of an insured.” There is no exclusion for residence employees based on relationship to the insured.

In a section entitled “Conformity to Statute,” the Additional Coverage Endorsement states: “Terms of this insurance which are in conflict with the [1192]*1192California Workers’ Compensation Law are amended to conform to that law.”

In November 1989, Leonard, Jr., then 35 years of age, was employed as a carpenter by Leonard, Sr., to perform repairs on a residential property in preparation for its sale. He injured his back in the course of his employment, while lifting machinery into his truck.

In November 1990, Leonard, Jr., filed an application for adjudication of a workers’ compensation claim. The application states that, at the time of the injury, he was earning $600 per week as Leonard, Sr.’s employee. His injury resulted in two surgeries and ongoing medical treatment. The Director of the Department of Industrial Relations (hereafter the Director), as administrator of the Uninsured Employers Fund, was joined as a party defendant.

In November 1992, the Director made a prima facie determination that Leonard, Sr., failed to secure workers’ compensation insurance as provided under Labor Code section 3700, based on the nonexistence of a record of such insurance with the Workers’ Compensation Insurance Rating Bureau. Leonard, Sr., petitioned the Workers’ Compensation Appeals Board for a determination of insurance coverage, on the ground that he had complied with the requirement of Labor Code section 3700 by purchasing a policy of workers’ compensation insurance from State Farm.

In October 1994, State Farm admitted that Leonard, Sr., was insured under the policy. The Uninsured Employers Fund was thereafter dismissed as a defendant.

State Farm stipulated that Leonard, Jr., was hired to perform work on a residential property covered under the policy and that he had worked more than 52 hours and earned more than $100 in wages in the 90 days before the accident.1 It contended, however, that Leonard, Jr., was barred from recovery of workers’ compensation benefits under Labor Code section 3352, subdivision (a), as the son of his employer. Leonard, Jr., contended that he was entitled to such benefits as a “residence employee” under the policy.

In March 1995, after a hearing, the workers’ compensation referee issued a an opinion concluding that Leonard, Jr., was a covered employee under the [1193]*1193workers’ compensation law. State Farm petitioned for reconsideration. The Workers’ Compensation Appeals Board denied reconsideration, adopting the referee’s opinion.

A writ of review by State Farm followed. The Court of Appeal concluded that Leonard, Jr., was not a covered employee under the workers’ compensation law and the policy, annulled the decision of the Workers’ Compensation Appeals Board, and remanded the matter for proceedings consistent with its opinion. We granted review.

II.

Insurance Code section 11590 provides, in relevant part: “[N]o policy providing comprehensive personal liability insurance may be issued or renewed in this state on or after January 1, 1977, unless it contains a provision for coverage against liability for the payment of compensation, as defined in Section 3207 of the Labor Code, to any person defined as an employee by subdivision (d) of Section 3351 of the Labor Code. Any such policy in effect on or after January 1, 1977, whether or not actually containing such provisions, shall be construed as if such provisions were embodied therein.” (Italics added.)

Under the statute, coverage for any person defined under Labor Code section 3351, subdivision (d), is both required and authorized in any policy for comprehensive personal liability. It is required in the sense that such policy must be construed as including such coverage, whether or not it actually contains express provisions to that effect. It is authorized in the sense that the liability insurer is permitted to include workers’ compensation coverage for persons defined under Labor Code section 3351, subdivision (d), even though, as a general matter, it is not admitted to transact workers’ compensation coverage.2

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947 P.2d 795, 97 Daily Journal DAR 15207, 16 Cal. 4th 1187, 62 Cal. Comp. Cases 1629, 97 Cal. Daily Op. Serv. 9452, 1997 Cal. LEXIS 7907, 69 Cal. Rptr. 2d 602, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-fire-casualty-co-v-workers-compensation-appeals-board-cal-1997.